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Bisphosphonate pretreatment attenuates hungry bone syndrome postoperatively in subjects with primary hyperparathyroidism

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Abstract

Primary hyperparathyroidism is characterized by hypercalcemia with loss of bone mass. After parathyroidectomy, hypocalcemia may develop in some patients due to unregulated bone mineralization. Preoperative administration of bisphosphonates, potent inhibitors of osteoclast activity, may prevent postoperative hypocalcemia after parathyroidectomy. We retrospectively reviewed medical records to investigate the effect of bisphosphonate pretreatment on serum calcium level changes after parathyroidectomy. Twenty-three patients with a diagnosis of primary hyperparathyroidism underwent parathyroidectomy between April 1997 and August 2002. Clinical and laboratory data were collected before and after the operation. These patients were divided into two groups; those showing hungry bone syndrome (n = 9) and those not (n = 14). None of the 9 patients with hungry bone syndrome had received bisphosphonate pretreatment. Of the 14 patients without hungry bone syndrome, 6 had received bisphosphonate pretreatment (P < 0.05). Furthermore, preoperative calcium concentration was not related to the occurrence of hypo-calcemia in those without bisphosphonate pretreatment. In conclusion, administration of bisphosphonates in primary hyperparathyroidism can prevent the occurrence of hungry bone syndrome after parathyroidectomy.

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Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Taichung Veterans General Hospital, No. 160, Sec 3, Chung Kang Road, Taichung 407, Taiwan, ROC

    I-Te Lee & Wayne Huey-Herng Sheu

  2. Department of Medical Education and Research, Taichung Veterans General Hospital, Taichung, Taiwan, ROC

    Wayne Huey-Herng Sheu

  3. Chung Shan Medical University, Taichung, Taiwan, ROC

    I-Te Lee & Wayne Huey-Herng Sheu

  4. Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan, ROC

    Shih-Te Tu

  5. Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan, ROC

    Shi-Wen Kuo & Dee Pei

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  1. I-Te Lee
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  2. Wayne Huey-Herng Sheu
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  3. Shih-Te Tu
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  4. Shi-Wen Kuo
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  5. Dee Pei
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Correspondence to Wayne Huey-Herng Sheu.

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Lee, IT., Sheu, WH., Tu, ST. et al. Bisphosphonate pretreatment attenuates hungry bone syndrome postoperatively in subjects with primary hyperparathyroidism. J Bone Miner Metab 24, 255–258 (2006). https://doi.org/10.1007/s00774-005-0680-x

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  • DOI: https://doi.org/10.1007/s00774-005-0680-x

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